Real Self-Care, page 8
The Three Yellow Flags on Your Real Self-Care Path
As you go through the principles of real self-care, it’s important to be clear as to what real self-care is not. There are three yellow flags, and it’s tempting to get caught up in them, fall away from the path of real self-care, and go right back to faux self-care. Pressure to revert to a cookie-cutter, one-size-fits-all mentality comes at us from all sides, so it’s worth stopping here to put the three flags on your radar.
Real Self-Care Is Not without Risk
To practice real self-care, you must be willing to make yourself vulnerable—whether that means having uncomfortable conversations to set boundaries or making the clear and deliberate choice to prioritize one aspect of your life over another. The good news is that these leaps of faith pay off in the long run: every decision that you make in the service of real self-care takes you further away from the oppressive systems that keep you down and brings you closer to who you are. There is always a cost—whether it’s financial, social, or emotional—and there is also a gain, in the form of emotional well-being, ownership of your time and energy, and ultimately, shifts in your relationships.
So, it makes sense that in order to do this work, we must cultivate courage. In her TED Talk called “The Power of Vulnerability,” [6] which has been viewed more than fifty million times, Brené Brown, PhD, makes the connection between risk and courage. Brown has spent the past two decades studying courage, vulnerability, shame, empathy, and what separates people who take risks from those who do not. Ultimately, Brown found that “these folks had, very simply, the courage to be imperfect. . . . They were willing to let go of who they thought they should be in order to be who they were.”
Building a life in which you take care of yourself will always come with risks—anyone who tells you that you can have it without a cost has an agenda to sell you. The good news is that the benefits come not only to you, as we saw with Clara, but also to those around you, and even the systems that you work inside. And the fact that our systems are so stacked against us is precisely why we must have the courage to face the inner work of real self-care.
Real Self-Care Is Not a Religion
Especially in times of social chaos or turmoil, it’s natural to look toward gurus or external sources of authority for the Answer. I’m perhaps most passionate about this yellow flag due to my personal history. Anyone who tells you that there is only one path to well-being should trigger the tiny hairs on the back of your neck. Real self-care requires us to subvert the paradigm that there is one answer to wellness. As you move through the tools in this book, remember that what I’m offering here is not canon. You will question my assertions, you will find that some of it is not for you, and you will not follow it to a tee. That means you are doing it right. You are not meant to use this book as a bible, because the entire premise of real self-care is that we as human beings can never expect to find a one-size-fits-all solution. We have to be careful not to become fanatical about any particular practice. We’re all vulnerable to the seduction of so-called gurus, but it’s especially true the more our social structures fail us.
Real Self-Care Is Not a Destination
When I found a publisher for Real Self-Care in 2021, I said to my therapist, Christie, how am I going to write this book? Am I qualified to take this on? I’m a self-described workaholic. Self-care is one of the most difficult propositions for me. I ended up falling for Big Wellness in the worst way—I joined a cult! With compassion, Christie, who has been by my side since my early days of leaving the cult, said, “Pooja, I have a feeling that writing this book is going to be a process of self-discovery and healing for you.” She was right.
Yes, I’m a psychiatrist, so I have the clinical training and the expertise, but as many of you know, taking your own advice is much more difficult than doling it out. I’m not here to give you advice from the top of the mountain. I’m here as a fellow traveler alongside you. And certainly there are days, weeks, even months when I fall back into my masochistic ways, beat myself up, forget to say no, and lose sight of what’s most important. I have guides who help me get back on track—like Christie, my family, friends, and colleagues who support me. I lean on this team, and I pick myself back up and try again. That’s the work of real self-care. There is no perfection, and there is also no checking it off the list and calling it done.
If it’s disheartening to you to learn that real self-care is not a neat and tidy solution, take some solace—remember back in Chapter 1 we talked about how faux self-care prescribes methods, whereas real self-care focuses on principles? This is critical because living by your principles is a lifelong process. Your circumstances will constantly change—whether you’re having a baby, transitioning into a new job, or navigating the challenges of caring for aging family members. You will constantly need to learn how to apply the principles of real self-care to novel situations, but you will become more practiced and confident in applying these principles. A tidy solution could never work for the long haul, and folks, we are in it together for the long haul.
CELEBRATE REAL SELF-CARE FAILS
Using these principles—even imperfectly—to guide your actions moves you in the direction of real self-care. There is no pressure to “get it right” and do it perfectly all the time. There will be situations in which you look back and say to yourself: “Wow, I really should have said no to that giant time suck of a work project,” or “Jeez, I spent an hour berating myself because I forgot to sign my kid up for summer camp.” This is normal and okay and expected. Not only that, it doesn’t take away from your progress of real self-care. This is the beauty of an internal, self-guided framework—it’s nonbinary, and simply by keeping these principles as a guide in the back of your mind, you’re doing enough.
Chapter 5
REAL SELF-CARE REQUIRES BOUNDARIES
MOVING PAST GUILT
To free us from the expectations of others, to give us back to ourselves—there lies the great, the singular power of self-respect.
JOAN DIDION
My patient Angela, thirty-two, had a tendency to be the fixer in her household. Run out of toilet paper? She’d jump up for the Target run. Boyfriend locked out of the apartment? She’d hop in a cab to save him. One day she shared a pretty revealing story with me. Angela and her boyfriend had recently moved in together and decided to adopt a puppy. She was juggling working part time as an executive assistant and getting her master’s degree in social work, and she was approaching her finals week. Not only that, on weekends, she had to do the clinical rotations required to finish her degree.
One Saturday, her boyfriend was out with friends while she was at her clinical site. That morning they’d made a plan for him to be home by 3:00 p.m. to take the puppy, Elie, for a walk. She received a text from him at 2:45 p.m. saying that his buddy wanted to grab dinner together, so he wouldn’t be able to make it home to walk Elie. He wanted to know if Angela could finish up her work early and make it home. Angela immediately rushed to the rescue, quickly finishing the last of her charting and asking her supervisor if she could make up her evening clinical shift the following weekend.
In our session that week, Angela shared this anecdote as an example of how, while her partner had dropped the ball, she was able to save the day. She was feeling good about her ability to juggle more than seemed humanly possible. She explained, “I know I’ll have to make up that evening shift, but we don’t have plans next weekend, so it worked out.”
I asked Angela why she decided to say yes to her boyfriend’s request when they had already made a plan that he would be responsible for Elie that afternoon. Didn’t this change in plans make more work for her? Angela was a little taken aback.
“Well, my supervisor was really flexible and so it’s fine.”
“But didn’t you come up with a plan that morning, and hadn’t he agreed to be responsible for Elie that afternoon?”
Angela, looking sheepish, said, “I guess it didn’t occur to me to say no to him. . . .”
I pushed her a little further. “I’m noticing that we have spent so much of our time together talking about how important your master’s program is to you. What do you think of the fact that you were willing to quickly drop your priority so your boyfriend could spend more time with his friend?”
In my practice, I see many women like Angela who struggle to set limits with their partners, families, and even friends. While Angela’s situation may seem extreme, you might notice varying degrees of this behavior in your own life. For instance, like Angela, in the heat of the moment you might not recognize setting a boundary is an option. Or perhaps you’re aware that you want to say no but are uncomfortable setting a boundary that might lead to conflict. Or perhaps you feel too much guilt to firmly communicate your choice. Failure to set boundaries not only mires Angela and women like her in unfulfilling activities, it also prevents them from having the mental and emotional bandwidth to engage in real self-care practices.
The first principle of real self-care, then, is setting boundaries. Boundaries are the cornerstone; without them, none of the rest of the work can happen. Real self-care is all about making space for you—your thoughts, feelings, and priorities in life. Most of my patients need to fight their way to having this space, because they don’t see their time and energy as belonging to them. And, again, this isn’t their fault. Our entire system is built on the premise that women’s time—and especially the time of Black and brown women—doesn’t belong to them. Setting boundaries is how we take our time, energy, and attention back.
WHAT EXACTLY ARE BOUNDARIES?
Think of boundaries as the energetic space between two people. Lest that sound a little too woo-woo, let me explain. When I was a new faculty member at George Washington University’s Department of Psychiatry and Behavioral Sciences, my mentor, Dr. Lisa Catapano, took me out for lunch. She had grown to be a friend as well as a mentor over the years, and we’d had many conversations about how to navigate the tricky terrain of being a woman in a male-dominated profession like medicine. Dr. Catapano, in her confident and tell-it-like-it-is manner that I’ve always found reassuring and compassionate, gave me a piece of advice that dramatically shifted my views about professional boundaries: You don’t have to answer your phone.
I was a bit stunned. This was the exact opposite of the training I’d received as a medical student and a resident. In those days, the dogma was “Be available at all times, answer your pages immediately.” That mentality of always being “on” carried over even when I wasn’t on call at the hospital.
“Let it go to voicemail,” Dr. Catapano said of my office line, “and listen to the message. See what the person wants and then take a couple of minutes to decide what you want to do.”
The idea that I not only was allowed to take time, but that in that space I could decide the best response, was nothing short of revolutionary to me. It didn’t matter whether the caller was the front desk staff telling me they had paperwork they needed me to sign or a patient who needed to reschedule an appointment. When I picked up my phone, I felt pressured to say yes and react. Not answering my phone and letting it go to voicemail gave me time and space to craft my response and be strategic about my time and energy.
My boundary was in the pause.
Inside the pause, it was up to me to decide how to answer. I could say, “Sure, let me take care of that right away.” Or I could say, “I’m back-to-back with patients all day. Can you put it in my mailbox and I’ll look at it tomorrow?” As a doctor, there are times when patients need me urgently. But by taking the step to let my phone go to voicemail, I’m not abandoning or ignoring anyone—I’m giving myself the time to respond instead of reacting. In fact, by taking ownership of my attention, I actually improve my ability to be available for my patients in those rare cases of emergency.
Setting boundaries is about recognizing you have a choice and communicating it. But before you can get to either of those things, you need to grapple with a gigantic obstacle that almost always rears its head: other people’s feelings. Because when you communicate a boundary, something tricky happens. Whether the boundary is set with a friend, a family member, or an elementary school’s PTA, there will likely be consequences, real or imagined. For instance, there are some who would recoil at my decision not to answer my office line. But boundaries are not cocreated. Other people will have their own feelings about your boundaries, but they cannot create them. A boundary is about what you need to interact in the world.
The tension between what you need and what other people in your life expect of you is at the core of why setting boundaries is difficult for many women, and so let me make the link plainly: Boundaries are hard not because you can’t identify yours, but because you are worried about the backlash. Remember this language and come back to it when coaching yourself through the difficult work of setting boundaries.
In this next section, I will share an exercise you can use to assess your real self-care level. Then, after you are equipped with this knowledge, the rest of the chapter will guide you through my framework for setting boundaries, which contains specific techniques for dealing with guilt, letting go of what other people think, and making requests. At the end of the chapter, I’ll answer common questions about setting boundaries that I often see in my practice.
THE REAL SELF-CARE THERMOMETER
When I assess a patient’s ability to practice real self-care, I don’t worry about whether they go to yoga every week or whether they are drinking enough water every day. Instead, over the years, I’ve found that my patients’ capacity to recognize that they have choices and their ability to communicate those choices is a fairly reliable measure of how well they take care of themselves. So, to start our work, I’ve created an exercise called the Real Self-Care Thermometer. The Real Self-Care Thermometer will help you measure your capacity to identify and communicate your boundaries in a number of commonly thorny life circumstances. Score yourself at the end to see which category you fall into (Red, Yellow, or Green). While each question in the Real Self-Care Thermometer may not exactly match your life circumstances, use your best guess as to how you might respond if it did.
Question 1
You’re on a weekend getaway with your closest friends. It took a year to organize everyone’s schedules and you’ve been looking forward to it for months. You’re just about to step into a yoga class when you get a text from your boss, who knows you’re offline for the weekend, asking if you could be so kind as to forward the spreadsheet you’ve been working on for a big client meeting the next week. Which answer best describes your response?
A. You immediately call your boss back, thereby missing yoga class, and offer to update the spreadsheet with the latest figures, skipping lunch in the process. (1 point)
B. You see the text and still go into the yoga class. After yoga and a relaxing lunch, you take five minutes to double-check that your out-of-office message was securely in place. You respond to your boss’s text while you’re at the airport on your way home, telling him where to find the spreadsheet, and let him know that you’ll be happy to discuss any updates to it on Monday morning. (3 points)
C. You see the text but still go to yoga. You have a hard time paying attention to your breath because your mind is preoccupied with work and wondering if you should have given clearer instructions to your team. You spend the class berating yourself for not reminding your boss (for a third time) of all the updates before you left. You convince yourself that leaving for the weekend so close to a big client meeting was a bad idea. By the end of yoga, you feel more tense than you did at the beginning of class. (2 points)
Question 2
It’s Thanksgiving and you are invited to your in-laws’ home for their yearly holiday gathering. They live across the country and air travel is exorbitant. You spend several holidays a year with this side of the family, so this is not the only chance to see them. Thanksgiving week is often packed with large group meals, activities, and events, and everyone is expected to attend. You’re juggling a particularly busy workload and also have small children who are difficult to travel with. What do you do?
A. You fork out the money for airfare, spend the full week with them, and partake in all activities. You come home exhausted and behind. Your kids’ routines are thrown off, and you deal with the consequences of that back home for another two weeks. (1 point)
B. During an argument about something completely unrelated, you bring up the Thanksgiving issue with your partner. You’re pretty angry when you bring it up and quickly cut to the chase—it’s not fair to spend so much time with his family over the holidays, especially during this busy year. Your partner disagrees with you, says you are overreacting. You acquiesce and end up spending the whole week there, feeling resentful, and coming home exhausted. (2 points)
